Post-Acute Kidney Sequelae Studied in COVID-19 Survivors

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The risk for kidney outcomes is increased for COVID-19 survivors in the post-acute phase of the disease, according to a study published in the September issue of the Journal of the American Society of Nephrology.

Benjamin Bowe, M.P.H., from the VA Saint Louis Health Care System, and colleagues examined kidney outcomes in a cohort of 1,726,683 U.S. veterans identified from March 1, 2020, to March 15, 2021, including 89,216 30-day COVID-19 survivors and 1,637,467 noninfected controls. The risks for acute kidney injury (AKI), estimated glomerular filtration rate (eGFR) decline, end-stage kidney disease (ESKD), and major adverse kidney events (MAKE) following acute infection were examined.

The researchers found that 30-day survivors of COVID-19 had an increased risk for AKI, eGFR decline ≥30 percent, eGFR decline ≥40 percent, eGFR decline ≥50 percent, ESKD, and MAKE (adjusted hazard ratios, 1.94, 1.25, 1.44, 1.62, 2.96, and 1.66, respectively) beyond the acute illness. The increase in risks for post-acute kidney outcomes varied depending on the severity of the acute infection. “Our findings emphasize the critical importance of paying attention to kidney function and disease in caring for patients who have had COVID-19,” a coauthor said in a statement. “If kidney care isn’t an integral part of COVID-19 post-acute care strategy, then we will miss opportunities to help potentially hundreds of thousands of people who have no idea that their kidney function has declined due to this virus.”

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